Heart Disease Symptoms in Women

WOMEN: HAVE QUESTIONS ABOUT HEART DISEASE?Stony Brook Heart Expert Has the Answers for This Often Misunderstood Illness

Heart disease is often thought of as a health problem for men, but more and more women die of heart disease each year than men, and from any other disease including breast cancer. One challenge is that some heart disease symptoms in women may be different from those in men.

Fortunately, women can start taking the steps needed to understand their unique symptoms of heart disease, which can also reduce their risk of this deadly disease. Kathleen Stergiopoulos, MD, PhD, cardiologist, Stony Brook University Hospital and Co-Director of the Women’s Heart Program, Stony Brook University Heart Institute, has the answers.

Q: What are the symptoms of a heart attack for a woman? Are they different in women than in men?A: The most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. However, the pain is not always severe or characterized as a pain. Pain may not be the most prominent symptom, rather shortness of breath, indigestion, palpitations, neck, shoulder, jaw, or back pain. Associated symptoms may be unusual nausea, vomiting, sweating, lightheadedness or unusual fatigue.

Many women seek medical care well into a heart attack, after much heart damage has occurred, because their symptoms are not typical of a heart attack, or they did not think they were at risk. If a women experiences any symptoms or thinks she may be having a heart attack, call for emergency medical help. It's best to call 911, rather than drive or get a ride to the hospital. There are two main reasons for this: Ambulances are equipped with defibrillators, which can save your life if your heart attack triggers an unstable heart rhythm. And, most Emergency Medical Services are equipped with 12-lead EKGs, which means they can transmit results to the hospital electronically en route. At Stony Brook, we assemble the treatment team and equipment you need before you arrive.

Q: What are the risk factors for heart disease in women?A: Traditional risk factors for coronary artery disease that affect both men and women are:

High blood pressure (hypertension)

High cholesterol

Diabetes

Family history of heart disease

Tobacco use

Age

However, other factors such as the metabolic syndrome (a combination of abdominal fat, high blood pressure, high blood sugar and high triglycerides) can affect women more than men. In addition, mental stress and depression can have a greater impact on women than on men.

Q: What can women do to reduce their risk of heart disease?A: There are several lifestyle changes that women can make to reduce their risk of heart disease:

Exercise for 30 to 60 minutes doing some sort of aerobic activity, such as walking, on most days of the week: Women who need to lose weight or sustain weight loss should get a minimum of 60 to 90 minutes of moderate-intensity physical activity on most, and preferably all, days of the week

Maintain a healthy weight

Quit or don't start smoking

Eat a diet that is low in saturated fat, cholesterol and salt

Visit your doctor on a regular basis

Have your blood pressure checked

Have your cholesterol checked

Medication is indicated if blood pressure is greater than 140/90, or greater than 130/80 in patients with diabetes or kidney disease

Treat known risk factors for heart disease, with the advice of your doctor

Some women benefit from a daily "baby" aspirin, but check with your doctor prior to starting any new medication

Q: Is heart disease something only older women should worry about?A: No. Women under the age of 65 who have any risk factors for heart disease should pay close attention to their symptoms. Women of all ages should take their heart health seriously.

Q: Can taking vitamins reduce a woman's risk of a heart attack?A: It is uncertain whether taking any vitamins can help reduce your risk of having a heart attack or developing heart disease. Antioxidant vitamin supplements (for example, vitamin E, vitamin C and beta carotene) should not be used for the prevention of heart disease in women. Folic acid, with or without B6 and B12 supplementation, should not be used for the prevention of heart disease in women.

Q: What is a "heart healthy" diet?A: The answer is simply this—you must consistently choose healthy eating patterns and healthy food selections, including a variety of foods:

Fruits and vegetables

Whole grains, high fiber

Fish, especially oily fish, at least twice per week

No more than one drink of alcohol per day

Less than 2.3 grams of sodium per day

Saturated fats less than 10 percent of calories and less than 300 mg of cholesterol per day

Q: What is an ideal body weight?A: Ideally, we want to maintain or lose weight through an appropriate balance of physical activity, calorie intake and formal behavioral programs, when indicated, to maintain the goal of having a body mass index, or BMI, for women between 18.5 and 24.9 kg/m² and waist circumference less than 35 inches.

Q: Should I avoid secondhand smoke? Can secondhand smoke increase your risk of having a heart attack?A: Secondhand smoke is a risk factor for having a heart attack. If you are regularly around smokers, encourage them to quit or go outdoors to smoke. This is especially important if you have had a heart attack or have been diagnosed with heart disease.